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Organization
SPARTANBURG MEDICAL CENTER
Active
Organization
SPARTANBURG MEDICAL CENTER
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
Other names
Medical Group of the Carolinas - Family Medicine - Landrum
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
Authorized official
KENNETH MEINKE (CHIEF FINANCIAL OFFICER)
(864) 560-6000
Entity
Organization
Contact information
Practice address
133 NORTH HOWARD AVENUE, LANDRUM, SC 29356-1507
(864) 457-3838
(864) 560-4413
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901474
—
NC
01
—
CN1627
RAILROAD MEDICARE GROUP#
SC
01
—
CN6119
RAILROAD MEDICARE GROUP#
NC
05
—
GP1118
—
SC
05
—
GP5633
—
SC
Enumeration date
06/02/2006
Last updated
12/09/2014
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